May 7, 2024

When Should You Treat High Blood Pressure As An Emergency?

Hypertensive crisis

When Should You Treat High Blood Pressure As An Emergency?

Hypertensive Crisis My Story

I believe that the best information comes from those who experience health problems and are bold enough to share their story. High blood pressure spikes are dangerous. For example a few years ago I was sitting with my wife on our porch enjoying the morning. The next thing I know my heart goes into afib, I get chest pain, and my blood pressure skyrockets. Five minutes later I found myself in the back of an ambulance being rushed to the hospital.

For the next three days I had one test after another. What they found was a complete shock. One of the arteries in my heart was 90% blocked. This had cause the afib and caused my blood pressure to skyrocket. Luckily I had a doctor who was not willing to send me home although I had no signs of a heart attack. She kept me and told me if I had not listened to my body I would have had a heart attack in two months.

Hypertensive crisis and high blood pressure

High blood pressure is a common condition in which the long-term force of the blood against your artery walls is high enough that it may eventually cause health problems, such as heart disease.

Blood pressure is determined both by the amount of blood your heart pumps and the amount of resistance to blood flow in your arteries. The more blood your heart pumps and the narrower your arteries, the higher your blood pressure.

You can have high blood pressure (hypertension) for years without any symptoms. Even without symptoms, damage to blood vessels and your heart continues and can be detected. Uncontrolled high blood pressure increases your risk of serious health problems, including heart attack and stroke.

Normal blood pressure for adults is defined as a systolic pressure below 120 mmHg and a diastolic pressure below 80 mm-Hg. It is normal for blood pressures to change when you sleep, wake up, or are excited or nervous. When you are active, it is normal for your blood pressure to increase. However, once the activity stops, your blood pressure returns to your normal baseline range.

What is a hypertensive crisis?

A “Hypertensive Crisis” can be life threatening and is a very scary thing to experience. I have been there and I do not want to experience it again. But what is a “Hypertensive Crisis”?

A hypertensive crisis is a severe increase in blood pressure that can lead to a stroke. Extremely high blood pressure, a top number (systolic pressure) of 180 millimeters of mercury (mm Hg) or higher or a bottom number (diastolic pressure) of 120 mm Hg or higher, can damage blood vessels. The blood vessels become inflamed and may leak fluid or blood. As a result, the heart may not be able to pump blood effectively.

What is the cause of hypertensive crisis?

Hypertensive crises are a common cause of medical urgencies or emergencies diagnosed in emergency rooms. Identification of risk factors for development of hypertensive crisis is important, so that specific patients at increased risk can be targeted for more aggressive therapy.

Those at risk for hypertensive crisis include patients with primary hypertension, a condition in which the cause of high blood pressure is unknown, and patients with secondary hypertension, high blood pressure that accompanies conditions such as renal disease, cardiovascular disease, sleep apnea, or pheochromocytoma.

A crisis in hypertensive patients can also be triggered by surgery, excess dietary salt intake, or a worsening of existing hypertension that goes undetected. In patients with or without existing hypertension, a hypertensive crisis can be triggered by neurological conditions, alcohol withdrawal, the use of illegal drugs like cocaine, or taking over-the-counter preparations that contain pseudoephedrine.

A hypertensive crisis is known to occur more commonly in males and in African-Americans. In addition, hypertensive crises are known to occur with a peak incidence between the ages of 40 and 50 years.

Signs & Symptoms of Hypertensive Crisis:

  • Severe chest pain
  • Severe headache, accompanied by confusion and blurred vision
  • Nausea and vomiting
  • Severe anxiety
  • Shortness of breath
  • Seizures
  • Unresponsiveness

If you experience a severe increase in your blood pressure, seek immediate medical attention immediately or call 911. Treatment for hypertensive crisis may include hospitalization for treatment with oral or intravenous medications.

Causes Of Hypertensive Crisis:

  • Forgetting to take your blood pressure medication
  • Stroke
  • Heart attack
  • Heart failure
  • Kidney failure
  • Rupture of your body’s main artery (aorta)
  • Interaction between medications
  • Convulsions during pregnancy (eclampsia)

Commonly affected organs/systems include:

  • Central Nervous System
  • Findings include Hypertensive encephalopathy, subarachnoid or intracerebral hemorrhage. In other words, it can cause a stroke or bleed in the brain.
  • Symptoms include: seizures, altered mental status (lethargy, coma, confusion), change in behavior, facial nerve palsy, hemiplegia

Renal System

  • Findings include: renal insufficiency/failure
  • Symptoms include: flank pain, dysuria, hematuria, frothy or tea-colored urine, oliguria/anuria
  • Note: often renal disease is the cause of hypertension in children, but rarely hypertension in children can lead to kidney damage as described above

Cardiovascular System

  • Findings include: congestive heart failure
  • Symptoms include: tachypnea, shortness of breath, orthopnea, paroxysmal nocturnal dyspnea, edema, S3 or S4, new or changed heart murmur

Vision Problems

  • Findings include: papilledema, retinal hemorrhages, exudates
  • Symptoms include: visual changes, deficits in peripheral vision

Educating yourself concerning is the biggest key to preventing a hypertensive crisis. If you have hypertension there are ways to control it, so that you are not faced with this problem. There are also ways that you can personally take responsibility for your hypertension. Just like a diabetic that avoids chocolate cake, there are things you should avoid. We all need to become our own healthcare advocates.

Things You Can Do To Help Yourself:

  • If you are overweight lose the weight. For every 20 lbs you lose you can drop your systolic blood pressure 5-20 points.
  • Quitting Smoking can naturally lower your blood pressure 5-10 points.
  • Getting more exercise can lower your numbers 5-15 points.
  • Decreasing caffeine intake lowers your diastolic pressure by 4-13 points
  • Decrease alcohol intake lowers your numbers 2-4 points.
  • Avoiding all processed foods lowers your numbers 10 points.
  • Decrease salt intake or stop altogether up to 25 Points.
  • Eat more fruits and vegetables
  • If your physician has prescribed medication, take as directed
  • Monitor your own blood pressure at home.

You do not have to experience a hypertensive crisis like I did. Although I did not see it coming and did not know I had hypertension, to begin with. A hypertensive crisis is dangerous and not to be taken lightly. But you have the power to make a difference in your own health.


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9 Replies to “When Should You Treat High Blood Pressure As An Emergency?”

  1. We do not recommend any particular medication. That is between you and your physician. But we do have many articles discussing natural ways to lower blood pressure.

  2. 9 years ago my BP registered 255/150. The doctor told me I should be dead! Some of this was white coat syndrome and some was poor diet. I read all of Dr. Fuhrmans books and Dr. Esselstyns’ books referenced above and just a few months later my BP dropped to 115/70 all without medication and has stayed that way ever since.

  3. The books are your best source of information as to how to keep yourself health. In addition to those referenced also read “Eat to Live” by Dr. Fuhrman. The chapter from that book that always resonated with me was “Digging our graves with forks and knives”

      1. Jason/Eli Ben -Yehuda: I will buy the books of Fuhrman, Esselstyn, & M. Greger. Question: How did you lower your bp WITHOUT medicine? What was your doctor’s advice,? My Bp right now is controlled bcoz I take a bp med low dose, and have not been on it for 6 months. But since I know that my high bp was caused by stress, specifically by lack of sleep, it caused my cortisol to be activated. I am working on my sleeping habits but it is nit easy bcoz I am the primary care giver of my elderly aunt. So the stress of caregiving has taken a toll on my mental & physical body. I eat a relatively healthy diet. I also notice that by me eating raw garlic, it does have a tremendous positive effect on lowering the pressure. But I would like to NOT take the bp med anymore. Please enlighten me more on how not to take the medicine. I also notice that intentional prayer helps greatly & gives a soothing calming relief. Thank you much.

  4. I think the key point to remember is that the hypertension typically has no symptoms even if very high. When accompanied by high cholesterol you have the building blocks of atherosclerosis which causes heart attacks and most strokes. A very healthy diet will cure all these things simultaneously without risky drug side effects.

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